What's your typical massage like?

Replies to This Discussion

Permalink Reply by Ivy Hultquist on October 11, 2009 at 12:26pm

I keep my sessions pretty basic, usually 30 minutes or less. I primarily use deep tissue techniques, ashiatsu, and ROM stretches. I recommend the use of ice more than heat.

What we also need to remember is in a group like this all of us have different scopes of practice depending on our education and the states we live in. Many of us cannot use ultrasound or e-stim machines as massage professionals. However, many massage professionals are also utilized as Chiropractic Assistants or Technologists (CA's or CT's) in chiropractic clinics and can use other modalities.

So where does everyone live and what other duties do you have on your practice in a chiropractic clinic?

Ivy
I-O-W-A!
Advanced Massage Techniques

Permalink Reply by Marilyn St.John on October 12, 2009 at 1:27am

Most of my sessions are 60 minutes long, and occasionally just 30. In this setting, I give a European massage that includes basic Swedish technique and always a bit of deep tissue work & ROM stretching and often include Lomi-Lomi, myofascial release & trigger point therapy. I use whatever combination of techniques get results in any given session ~ different strokes for different folks (sorry, couldn't resist that!) There are even times when Reiki works to relax those who are very sensitive or if a quick application of heat or cold is appropriate; and of course, actual heat packs if necessary, or I can apply Biofreeze and they can use ice at home. The chiros I work with don't typically use any extra equipment themselves, and even though I'm trained in ultrasound (from a past career) I fail to see how it would be at all beneficial in this setting...or cupping either, now that you mention it...at least not in the setting I'm in.

Permalink Reply by Serenity Achieved! on February 5, 2010 at 3:20pm

I typically work on chiropractic patients for 60 minutes, occasionally I have requests for 90 minute sessions. Most of the work I do is some combination of craniosacral therapy, neuromuscular therapy, active isolated stretching and myofascial release. I am trained in other modalities, but for the type of patients I see, those work really well together. The chiropractor I work with is very alternative and energy based, so I also do a lot of Reiki, Seichem and work with crystals and other energy modalities in combination with muscle work; the results are pretty incredible combining the two.

When I cover the front desk (if chiro assistant is on vacation) I will put patients on stim with heat or ice, but don't ever use e-stim at part of a massage/bodywork session. Our office doesn't use ultrasound at all. I am taking a cupping class later this month and will definitely incorporate that technique into sessions. If a patient comes in for a session with me with significant inflammation I will apply an ice pack and my table has a table warmer on it the most of the patients love and are upset if I turn it off because I find inflammation.

Having worked for a chiropractor for 11 years I have to say, there is nothing "typical" about working on chiropractic patients. They come in for a variety of reasons and their session is tailored specifically to each patient's treatment plan.
Susan
in PA

Permalink Reply by Jacqueline Gomez on February 6, 2010 at 6:30pm

Hey Logan, I therapy treatments generally focus on what has brought the client/patient to a chiropractor. We do use water hydrocollators. We also do a lot of MFR, NMT, MET, Active and Passive Stretching. If I see a client before the doctor I try to losen them up for him. If I see them after I ask how did the adjustment go? Some people feel pain right after because they resisted the doctor during the adjustment. Also if i see them after I try to focus on maintaining the movement of the jts.

I would love to hear any advice or additional ideas anyone has to offer. ~ Jacquie, VA

Permalink Reply by Stephen Jeffrey on February 19, 2010 at 5:12am

I'm in the UK and I'm greatly concerned that far too much focus is put on working where the pain is, eg spine.

Its sometimes very difficullt to keep the client "on board" mentally when I say we need to be working on the feet, legs and pelvis. They come expecting me to work where the pain is (but I've had this problem for years and no one has worked on my legs they say !) and I do for the first session only as a way of meeting their expectations and showing I am a talented therapist who wants them fixed permanately/longer.

Firstly I get them to stand on two scales so I can check weight distribution down from the pelvis. Then I work the feet focusing on the planter fascia as this will relax/release fascia/tension throughout the body. I release all tension points via triggerpoint ichemic compression.

Then on the calf muscles I focus on releasing the medial tib border (its rare to find anyone who does not have probs here) of fascial restrictions/shin splints.

Then side lying with top leg at 90 degrees and bottom leg nearly straight focus on sartorious (leg twister pelvis distorter) and adductors, check pes anserinus for adhesions.Top leg, cover hip with towel (as this can feel v intimate) and use thumbs gentle dabbing getting firmer in arc from greater trochanter to treat gluetes piriformis TFL then under G tronchanter to treat hip rotaters (special focus on quadratus femoris) then ITB, V lateralis trigger points. ITB Tibialis attachment adhesions.

Check in with your client as you do the above and most will report feeling the site of pain melting away before you even start working the spine muscles.

Warn your chiro less force will be needed to make the adjustments ! !

I used the above "routine" on a recent client visiting from Australia (known for their healthcare prowess) who had suffered low back pain and headaches for 8 yrs. Two 2hr sessions = 70% improvement.

Do you focus enough on feet, legs pelvis in your approach to spine pain ??

Permalink Reply by Ray Mingo on February 19, 2010 at 8:54am

What's up Logan good question. Personally I think that a massage therapist who works for a chiropractor are different from one that works on a cruise ship or spa. This has nothing to do with who is better it just means their different (every massage therapist have a purpose whether they work in a spa or in a chiropractic office). As for those who work with chiropractor/osteopathic doctors, orthopedic doctors, etc. Our knowledge of the muscular skeletal system, muscles imbalance/posture distortion, pain, referred pain, muscle texture, is imperative for complementary therapy.

When I see a client after they've seen the chiropractor I perform my own initial assessment on them. I personally would rather perform 45 mins. addressing their muscular problems than just giving them a 60 min. full body relaxing massage. I rely on my assessment of the client’s range of motion, end field off joints, flexibility. I look for head tilt, shoulder height/rolled shoulders, pelvic distortion as they walk in the office. While on the table I also compare the difference in hip and height and angle and also do the same with the shoulders and look at the feet and how they set compared to each other. I do all this in conjunction with talking to them about what brought them to the office. I do this for all my clients on their first visit and some on their second visit. Some clients wonder why I'm spin more time on muscles like piriformis, hamstring, adductors/abductors, and hip flexors and less or very little on their low back where they are having pain.

I do this same evaluation 3-6 month later and I see the difference in their range of motion, flexibility, and the hips begin to appear even and the client experiencing less pain. But with all that I like you am constantly looking for improvement. Thanks for the post Logan.

Permalink Reply by Michael A. Breaux on February 27, 2010 at 5:48pm

I've been a clinical massage therapist for 20 years, the last 17 at a local chiropractic clinic in Lake Charles, Louisiana. My routine is to perform 1 or 2 units of 15 minute manual therapy treatments to area specific problems. I do about 10 clients in a half day session. We bill insurance using the 97000 series codes and charge about $50 per 15 minute treatment. I usually focus on one area for each 15 min of work: 1. Low back, glutes, legs, psoas 2. Shoulder, rotator cuff, traps, levator rhomboids, scalenes, pecs, delts, biceps, triceps 3. Neck, traps, levator, splenii, scm, suboccipitals.

My routine consists mainly of trigger point compression, crossfiber, and effleurage to the limit of the client's pain threshold.
I also use towel traction for cervical injuries when indicated and find Paul St. John's pelvic stabilization protocol indispensable for leg length descrepancies.

Personal injury clients (those hurt in automobile accidents, maritime accidents, or workplace accidents where another party is liable) constitute about 60 to 70% of my clientele. The rest are major medical insurance policy holders. Although I am crosstrained, we have several chiropractic assistants that take care of ice, heat, ultrasound, cold laser, and electrostim..This leaves me free to do what I'm best at - massage. We also have a DTS traction machine as well as an excercise and rehab room. We have 3 chiropractors and 1 other massage therapist on staff. Note about Personal Injury - in Louisiana a person can also get pain and suffering compe$ation for their injuries as well as payment for their treatment and attorney fees.

I've worked in hospital, physical therapy clinic, and chiropractic clinic settings. I also have a private practice where I do clinical and sports massage as well. I've had the good fortune to work with some very talented people, including my wife, Susan Salvo. I specialize in post surgical rehab (everything from plastic surgery to joint replacement to clients in halo braces) and sportsmassage (most of the ladies PGA, an Olympic silver medalist, a professional javelin thrower, and lots of triathalon and marathon runners, college and high school athletes, etc). If you've got a question, ask and I'll try to help.

Permalink Reply by Michelle Batac on January 10, 2011 at 12:15am

This is a good question since all chiropractors differ so much, just as we massage therapists do. I work in two different offices. One doesn't do any manual treatment, just adjusts. There it it always 30 or 60 minutes of whatever I find necessary for the best therapeutic result for the patient. This may be relaxation, D.T., heat, ice, you name it. On the flip side, the other doc uses Graston on the patients, e-stim, ultrasound, Kinesio Tape, heat, ice, Thumper Pro, manual stretches, TrP therapy. That being said, she let's me do whatever too, but tells me sometimes to do specific work, D.T. Or circulatory type massages, usually for 50 minutes, occasionally 25 minutes and rarely 80 minutes.
I started incorporating Gua Sha techniques, and even some form of cupping eventually.